Department of Health and Social Care

Fertility: Medical Treatments

Baroness Deech: To ask His Majesty's Government whether they have any plans todevelopa national tariff for fertility treatment in order to achieve a strategy to achieve best value for the NHS.

Lord Markham: A benchmark price for in-vitro fertilisation and intracytoplasmic sperm injection remains part of the new NHS Payment Scheme. There are no current plans to develop a national tariff for these treatments.

Brain: Tumours

Baroness Randerson: To ask His Majesty's Government, further to the All-Party Parliamentary Group on Brain Tumours reportBrain Tumours: Pathway to a Cure — breaking down the barriers, published on 28 February, whether they have accepted recommendation six contained in that report that specific funding should be ring-fenced for research into childhood brain tumours; and if so, what is the timescale for implementation.

Lord Markham: It is not usual practice to ring-fence research funds for particular topics or conditions. As with other Government funders of health research, the National Institute for Health and Care Research (NIHR) does not allocate funding for specific disease areas. Applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to patients and health and care services, value for money and scientific quality. The Department welcomes the APPG report, recommendations of which continue to be worked through with the Department of Science, Innovation and Technology, and UK Research and Innovation and the Medical Research Council (MRC), and with the NIHR.

NHS: Drugs

The Marquess of Lothian: To ask His Majesty's Government how many Serious Shortage Protocols (SSPs) for medication or medical appliances are currently in place owing to a national or worldwide supply shortage; for which medications treating which conditions are these SSPs in place; and what steps they are taking to support affected patients, in particular, those patients facing a shortage of prescribed medication to help manage their ADHD symptoms.

Lord Markham: There are currently three Serious Shortage Protocols (SSPs) in place. These are for Estradot 100microgram hormone replacement therapy patches for treatment of the menopause, clarithromycin antibiotic 125mg/5ml oral suspension and clarithromycin antibiotic 250mg/5ml oral suspension for the treatment of a variety of infections including chest infections and other respiratory infections.A team within the Department deals specifically with medicine supply problems arising both in the community and in hospitals. It has well-established procedures to deal with medicine shortages and works closely with the Medicines and Healthcare products Regulatory Agency, the pharmaceutical industry, NHS England and others operating in the supply chain to help prevent shortages and to ensure that the risks to patients are minimised when shortages do arise.We are aware of supply issues affecting medicines used in the management of attention deficit hyperactivity disorder (ADHD). We have issued communications, in the form of a National Patient Safety Alert to the National Health Service, to advise healthcare professionals on the management of patients during this time. We continue to work closely with the manufacturers to resolve the issues as soon as possible and to ensure patients have continuous access to ADHD medicines in the United Kingdom. Supply disruptions affecting various ADHD products are resolving and we anticipate the supply of the remaining medications to resolve between now and December 2023.Patients are advised to speak to their clinician regarding any concerns they have and to discuss the suitability of treatment with alternative medicines.

Diffuse Intrinsic Pontine Glioma: Research

Baroness Randerson: To ask His Majesty's Government how much funding they have allocated for research into the treatment of Diffuse Intrinsic Pontine Glioma brain tumours in children in each of the last 10 years; and to which organisations were those funds allocated.

Baroness Randerson: To ask His Majesty's Government whatcollaborative research they are currently funding in partnership with other countries into childhood brain tumours, including Diffuse Intrinsic Pontine Glioma; and whether this includes funding for access to clinical trials.

Lord Markham: The following table shows eight research studies around Diffuse Intrinsic Pontine Glioma, funded by research funding partners in the charity and public sectors since 2013 which have been supported by the National Institute for Health and Care Research (NIHR):Study TitleOpening DateClosure DateFundersStatusPhase I trial of afatinib in paediatric patients with neuroectodermal tumours and rhabdomyosarcoma13/07/201505/05/2020Boehringer Ingelheim LtdClosed to Recruitment, Follow Up CompleteA Phase I/II, Multicenter, Open-Label, Dose-Escalation Study of the Safety and Pharmacokinetics of Cobimetinib in Pediatric and Young Adult Patients with Previously Treated Solid Tumors25/08/201631/12/2018F. Hoffmann-La Roche LtdClosed to Recruitment, In Follow UpBiological Medicine for Diffuse Intrinsic Pontine Glioma Eradication (Biomede)14/04/201729/09/2019Cancer Research UKClosed to Recruitment, In Follow UpPhase Ib /II Clinical Trial of Nivolumab Monotherapy and Nivolumab in Combination with Ipilimumab in Pediatric Subjects with High Grade Primary CNS Malignancies14/08/201722/02/2019Bristol-Myers Squibb International CorporationClosed to Recruitment, In Follow UpA PHASE 2 CLINICAL STUDY OF POMALIDOMIDE (CC-4047) MONOTHERAPY FOR CHILDREN AND YOUNG ADULTS WITH RECURRENT OR PROGRESSIVE PRIMARY BRAIN TUMORS17/10/201727/09/2018CELGENE CORPORATIONClosed to Recruitment, In Follow UpA Phase 1/2, Single-arm Study to Evaluate the Safety, Pharmacokinetics, and Antitumor Activity of Avapritinib in Pediatric Patients with Solid Tumors Dependent on KIT or PDGFRA Signaling15/02/202331/01/2025Blueprint Medicines CorporationSuspended****** *** Please note that the 2 commercial studies, due to the commercial sensitivity, cannot be shared more widely or made public. NIHR provides infrastructure support to studies taking place in the National Health Service. For example, staff, research nurses, local networks and NHS trusts will work across many studies, to varying degrees. As a result, NIHR cannot provide precise information on expenditure. The NIHR Clinical Research Network supports the delivery of high-quality research across the NHS, community and social care and public health organisations. It does this by meeting the costs of additional staff, facilities, equipment and support services. In May 2018 the Government announced £40 million for brain tumour research as part of the Tessa Jowell Brain Cancer Mission. The Government is committed to funding high-quality brain cancer research. The £40 million funding remains available.

Cancer: Children

Baroness Randerson: To ask His Majesty's Government whether they have any plans to develop a bespoke research strategy for childhood cancers with the worst survival rates, includingDiffuse Intrinsic Pontine Glioma; andwhat steps theyare taking to encourage drug development to treat those cancers.

Lord Markham: The Department invests over £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). The NIHR funds and supports health, public health and social care research that leads to improved outcomes for patients and the public and makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including childhood cancers.The Department does not directly commission research; rather, we invite funding applications for research into any aspect of human health. As with other Government funders of health research, the NIHR does not allocate funding for specific disease areas. The level of research spend in a particular area, is driven by factors including scientific potential and the number and scale of successful funding applications. It is also worth noting that all applications that were fundable in open competition have been funded.

Department for Transport

Aviation: Industrial Disputes

Lord Balfe: To ask His Majesty's Government whether they intend to use the provisions of the Strikes (Minimum Service Levels) Act 2023 to override a pilot's discretion to make the final decision as to whether the aircraft takes off as provided under international aviation regulations.

Baroness Vere of Norbiton: Any decisions by the pilot in command of an aircraft made in accordance with relevant aviation safety requirements, with regard to the safety of a particular flight, would not constitute industrial action. Such decisions are therefore outside of the scope of Part V of the Trade Union and Labour Relations (Consolidation) Act 1992 and the amendments being made to that Part by the Strikes (Minimum Service Levels) Act.

Department for Environment, Food and Rural Affairs

Rivers: Flood Control

Baroness McIntosh of Pickering: To ask His Majesty's Government what assessment they have made of the contribution of the Environment Agency to the regular maintenance of major rivers and water courses; and what assessment they have made of whether any lack of maintenance has contributed to recent flooding.

Lord Benyon: There are around 238,000 assets registered by the Environment Agency that have a flood or coastal risk management purpose in England, including 76,000 assets owned and maintained directly by the Environment Agency, plus approximately 162,000 assets owned by other parties including Risk Management Authorities and Private owners. Of these, 64,000 are classified by the Environment Agency as high consequence system assets – meaning those which provide the greatest level of protection to people and property. Assets are used to maintain major rivers and water courses. The Environment Agency regularly inspects over 154,000 assets that have a flood or coastal risk management purpose in England whether owned and maintained by the Environment Agency or other Risk Management Authorities or private individuals. The Environment Agency is currently inspecting assets impacted by Storms Babet and Ciaran. The Environment Agency estimate 2,300 properties flooded during these recent storms, with 139,000 properties better protected by flood and coastal risk management schemes. As of October 2023, (prior to the recent Storm Babet and Ciaran), the number of Environment Agency assets that were at or above the required condition in a high consequence Risk Management System was 94.5%. For assets owned or maintained by other parties this was 90%. A high consequence system is a location where there is a high concentration of properties. Flood risk is reduced by several flood defences working together to protect an area. Where assets are below their required condition this identifies that work is required. This does not mean assets have structurally failed or that performance in a flood is compromised. The Environment Agency publishes details of planned maintenance activities in the river and coastal maintenance programme, and further details can also be found in the Flood and coastal erosion risk management annual report (see attached).flood/coastal risk management report (pdf, 6810.7KB)

Rivers: Flood Control

Baroness McIntosh of Pickering: To ask His Majesty's Government what assessment they have madeof whether slumps in embankments in rural areas contributed to recent flooding events; and what steps they are taking to ensure embankment slumps are repaired.

Lord Benyon: The Environment Agency works closely with other Risk Management Authorities such as local authorities and Internal Drainage Boards to manage flood risk. The Environment Agency maintains over 7,300km of embankments. In the last two years about 25% of the resource allocation from Flood Defence Grant in Aid was spent on maintaining our embankments. The Environment Agency has been inspecting assets that may have been impacted by recent storms Babet and Ciaran. Over 2,200 inspections have been undertaken by Environment Agency inspectors and supply chain partners to date. Some assets are still not accessible due to ongoing high-water levels, and to get a full picture on the range of impacts may take a few weeks. If the performance of an asset is reduced, then action will be taken to ensure that flood risk continues to be effectively managed until the asset meets the required condition. The Environment Agency continues to have people on the ground supporting local communities and inspecting flood defence assets, and where required is developing plans based on the level of risk to return assets to their required condition.

Export Health Certificates

Baroness Ritchie of Downpatrick: To ask His Majesty's Government how they will work with trading partners to ensure thatthe capacity and availability of certifiers for export health certificates are sufficient to prevent any barrier to trade.

Lord Benyon: The UK Government is working closely with EU member states and the European Commission to ensure that there is sufficient certifier capacity for implementation of the Border Target Operating Model (BTOM). Our evidence suggests that member states will be ready with the necessary certifier capacity in place. We remain in contact with the European Commission to discuss and review the availability of EU certifiers to exporters, as it is the responsibility of the exporter to identify a certifying officer in the EU. Furthermore, under the BTOM’s risk-based approach most imports of animal and plant products will not require health certification. Where certification is needed, it will be simplified and digitised.

Department for Business and Trade

Fireworks: Regulation

Lord Black of Brentwood: To ask His Majesty's Government whether they have any plans to ban thesale of domestic fireworks in England; and if not, whether they will undertake a consultation on that subject.

The Earl of Minto: The majority of individuals who use fireworks do so in a responsible and safe manner. There are enforcement mechanisms in place to tackle situations when fireworks are misused. The Government has no plans to ban the sale of domestic fireworks or consult on this matter at this current time.